Provider Demographics
NPI:1619270840
Name:ERCA IMAGING CENTERS
Entity Type:Organization
Organization Name:ERCA IMAGING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:KUTSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-403-1300
Mailing Address - Street 1:6501 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2610
Mailing Address - Country:US
Mailing Address - Phone:972-403-1300
Mailing Address - Fax:
Practice Address - Street 1:6501 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2610
Practice Address - Country:US
Practice Address - Phone:972-403-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ER CENTERS OF AMERICA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR25027261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology